Blogs by Kara Wahlin, describing common issues faced by parents in the NICU and providing support and guidance for families facing them. Topics ranging from NICU discharge, advocacy in the NICU, interviews with NICU nurses, the struggles of quarantine, feeding challenges, coping with unsympathetic and/or oversympathetic family members or friends, book reviews of preemie stories, discussion of psychological issues faced by NICU parents, trauma, depression, stress and ways of coping through art and traditional therapy. This blog is a forum for NICU parents to find support during or after their infant's hospitalization in the NICU.

A few things I know now about my memory of the NICU; the things that will never be the same again: I will never be able to smell the hospital-brand hand sanitizer-- stoically and silently perched in plastic holders like mute witnesses along the hallways (the same stuff that almost rubbed my hands raw after at least a dozen applications daily)-- I'll never smell it again without my guts lurching.

I will never be able to hear incessant beeping without remembering desperately looking to see whether it indicated a de-sat or bradycardia event descending upon one of my babies, a flood of information swarming my thoughts-- "is it real or did a wire come loose? Is he dusky? What are the levels?" all the while my stomach dropped and it felt like the world was closing in-- darkness creeping into my peripheral vision, my senses focusing in on the one important thing before my eyes-- my sons.

I'll never again listen to Chopin's Ballades without feeling the groundless, terrifying, heartbreaking yearn to feel my son William's skin against mine, his sweet head tucked safely into my clavicle: it was the only music we would have time listen to together before his death.

These things have new meanings now. Some of which didn't present themselves until I had the sensory experience of hearing, smelling or feeling them again: I had to re-experience them to remember.

The mind has a tricky way of working sometimes. When it comes to our memories, the events that challenge our very being most horrifically oftentimes become coded as the most important things to remember in our minds. What’s more, it’s being increasingly verified through research that we remember these events in the lower parts of our memory system, meaning that these memories often come to the surface as re-experiencing, sensory events, as opposed to stories that we have access to, stories we can use language to describe, stories with beginnings, middles and ends.

The lower part of our brain systems work much like that of other mammals. While domesticated animals have the beginnings of a pre-frontal cortex (the pre-frontal cortex is where language, logic, and coherent communicable thoughts reside), animals' limbic and reptilian systems are fully developed and serve the same functions that those areas of our human brains serve-- basic survival functions like heart rate, blood pressure, breathing and muscle function in the reptilian brain (amongst other critical things!), and survival instincts based on the fight, flight or freeze instinct in the amygdala, part of the limbic system. These three parts of the mind-- prefrontal cortex, limbic, and reptilian systems-- make up what we refer to as the "triune brain".

Because it's the lower, unconscious part of our brains that take responsibility for our survival instinct, many times that instinct comes forward in moments we don't expect it to, sort of like the body's innate strategy to jump into action before you even know there's a lion behind you.

Everyone has two memories. The one you can tell and the one that is stuck to the underside of that, the dark, tarry smear of what happened.

— Amy Bloom

Since threatening memories are "coded" as sensory experiences, and remembered not only as what happened, but also the way it felt when we experienced it, trauma memories can come to structure our perspective. It can also make us feel like the trauma has never ended; as if at any time something bad could happen again. Many individuals who have experienced trauma report feeling as if “the other shoe will drop” weeks, months, even years after they’ve been through a crisis-- sometimes they actively look for the threat in an effort to have even earlier warning and thus, more time to respond.

This can have numerous effects on our ability to remain present, to be in the moment, and in our ability to experience things as spontaneous or enjoyable. If our brains are focused on survival, warning signs of threat, and the sensory memories of trauma, what focus is left to expend on being in the moment? How can we shift ourselves from living in response to the things that are happening to us, towards living freely.... liberated to being in the moment and being open to new things? Is there any way to extricate the trauma from our first memories of our relationships with our babies?

According to Bessel Van Der Kolk, leading researcher in trauma-related therapies, an important part of the healing is the physical component of rewriting the experience of certain sensory-related things. Hence, there is an answer in the idea that the more we hold our babies skin to skin, even after the NICU, that the memory of what it feels like to hold them in an unhindered environment will eventually supercede that of the NICU trauma memory. The more we smell hand sanitizers in a non-crisis-related environment, the less likely it will be that we will have a panic attack when smelling it. The more that we experience happiness in the context of our parenting experiences, the more likely the trauma will become a memory, and not a structural component of our relationships with our families.

Reference:

Van der Kolk, B.A. (2014). The body keeps the score: Brain, mind and body in the healing of trauma. New York: Viking.

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NICU Healing

NICU Healing is an online therapeutic resource designed for families currently in the NICU, recently released from the hospital, or coping with the residual effects of the trauma they experienced in having a preterm or medically complex infant. This site offers parents and family members access to free tips, educational materials and resources; it also offers a brief (6-8 week), for-pay group therapy program designed to help parents to cope with the trauma and depression that can be triggered by the NICU experience, and to understand, solidify and strengthen their attachment with their baby.